Provider and Pharmacy Directory. The Contractor shall make its Provider and Pharmacy Directory available to Providers via the Contractor’s web-portal.
Provider and Pharmacy Directory. The CICO shall make its Provider and Pharmacy Directory available to Providers via the CICO’s web-portal. The CICO shall educate Providers through a variety of means including, but not limited to, Provider alerts or similar written issuances, about their legal obligations under state and federal law to communicate with Enrollees and Eligible Beneficiaries with limited English proficiency, including the provision of interpreter services, and the resources available to help Providers comply with those obligations. All such written communications shall be subject to review at SCDHHS’ and CMS’ discretion. Subcontracting Requirements The CICO remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the CICO subcontracts for performance of any Contract responsibility. The CICO shall require each First Tier, Downstream, or Related Entity to meet all terms and requirements of the Contract that are applicable to such First Tier, Downstream, or Related Entity. No subcontract will operate to relieve the CICO of its legal responsibilities under the Contract. The CICO is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream, and Related Entities. First Tier, Downstream, and Related Entities are required to meet the same federal and state financial and program reporting requirements as the CICO. The CICO is required to evaluate any potential CICO prior to delegation, pursuant to 42 C.F.R. § 438.230. Additional information about subcontracting requirements is contained in Appendix E.. The CICO must establish contracts and other written agreements between the CICO and First Tier, Downstream, and Related Entities for Covered Services not delivered directly by the CICO or its employees.
Provider and Pharmacy Directory. The ICO shall make its Provider and Pharmacy Directory available to providers via the ICO’s web-portal. Upon request, the ICO must be able to provide a paper copy to providers.
Provider and Pharmacy Directory. The ICO shall make its Provider and Pharmacy Directory available to providers via the ICO’s web-portal. Upon request, the ICO must be able to provide a paper copy to providers. The ICO shall educate providers through a variety of means including, but not limited to, provider alerts or similar written issuances, about their legal obligations under State and Federal law to communicate with Enrollees and Potential Enrollees with limited English proficiency, including the provision of interpreter services, and the resources available to help providers comply with those obligations. All such written communications shall be subject to review at MDHHS’s and CMS’ discretion. Subcontracting Requirements The ICO remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the ICO subcontracts for performance of any Contract responsibility. The ICO shall require each First Tier, Downstream or Related Entity to meet all terms and requirements of the Contract that are applicable to such First Tier, Downstream or Related Entity. No subcontract will operate to relieve the ICO of its legal responsibilities under the Contract. The ICO is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream and Related Entities. First Tier, Downstream and Related Entities are required to meet the same federal and State financial and program reporting requirements as the ICO. The ICO is required to evaluate any potential First Tier, Downstream or Related Entity prior to delegation, pursuant to 42 C.F.R. § 438.330. Additional information about subcontracting requirements is contained in Appendix C. The ICO must establish contracts and other written agreements between the ICO and First Tier, Downstream and Related Entities for Covered Services not delivered directly by the ICO or its employees; The ICO must require that First Tier, Downstream and Related Entities afford Enrollees the opportunity and assistance with filing a Grievance, Appeal, or State Fair Hearing, and require procedures and timeframes for doing so, as well as the rules for representation at hearing; and that First Tier, Downstream and Related Entities must permit an Enrollee to request continuation of benefits if the Enrollee files an Appeal or a request for a State Fair Hearing within specified timeframes; and the ICO must provide the toll-free numbers to file oral Grievances and Appea...
